I need some expert advise on a CPT code for this procedure please. This patient had a Right Video-Assisted Thoracoscopic chest wall hernia repair s/p mitral valve repair 1 year ago.
Underneath the pectoralis there was a serosal cavity corresponding to the location of the bulging in the patient's chest below his pectoralis and nipple areolar complex. We then used cautery and sharp dissection as well as agitated with a sponge to scar down. We then placed stitches around the ribs, a combination of #2 Ethibond and #1 Ethibond. With the ribs retracted towards each other, we tied these down. The ribs moved maybe a 0.5 cm towards each other, still with a defect. However, the stitches did appear to be in good position to prevent any bulging from the lung and keep the ribs approximated in this location. These were placed with the video assistance in order to avoid intercostal vessels. We then placed several 0 Vicryl stitches behind the pectoralis, reapproximating as much soft tissue as we could including the posterior pectoral fascia. We then placed a 10 Blake drain through a separate stab incision at the patient's prior drain site and then coiled this outside of the chest cavity below the pectoralis muscle, cutting half of it off. This was done to keep some mild suction and keep this area flattened down so that there could be adhesion.
Thanks for any help in advance
Underneath the pectoralis there was a serosal cavity corresponding to the location of the bulging in the patient's chest below his pectoralis and nipple areolar complex. We then used cautery and sharp dissection as well as agitated with a sponge to scar down. We then placed stitches around the ribs, a combination of #2 Ethibond and #1 Ethibond. With the ribs retracted towards each other, we tied these down. The ribs moved maybe a 0.5 cm towards each other, still with a defect. However, the stitches did appear to be in good position to prevent any bulging from the lung and keep the ribs approximated in this location. These were placed with the video assistance in order to avoid intercostal vessels. We then placed several 0 Vicryl stitches behind the pectoralis, reapproximating as much soft tissue as we could including the posterior pectoral fascia. We then placed a 10 Blake drain through a separate stab incision at the patient's prior drain site and then coiled this outside of the chest cavity below the pectoralis muscle, cutting half of it off. This was done to keep some mild suction and keep this area flattened down so that there could be adhesion.
Thanks for any help in advance